| NPI | 1144647843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101260315) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D94712) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: PA MT200073) | |
| 207ZC0006X Pathology, Clinical Pathology (Licence: DC MD600005981) | |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2026-05-20 |